Prevalence of temporomandibular disorders in adult obstructive sleep apnoea patients: A cross-sectional controlled study

Background: Obstructive sleep apnoea (OSA) is characterised by partial or complete obstruction of the upper airways during sleep and it has been associated with temporomandibular disorders (TMDs) on the basis of several pathophysiological hypotheses. Objectives:To assess the prevalence of TMDs in a population of patients affected by OSA compared to a control group of subjects not affected by OSA. MethodsA cross-sectional controlled study was conducted on a group subjects studied by polygraphy (PG) at the snoring section of the ENT department, Sant'Orsola-Malpighi Hospital - University of Bologna. Patients who received a diagnosis of OSA were included in the study group and subjects with a negative PG diagnosis for Sleep Disordered Breathing and PG respiratory pattern that did not suggest the occurrence of sleep disorders were enrolled in the control group. Both the subjects included in the study group and the control group underwent an examination following the Diagnostic Criteria for Temporomandibular Disorders Axis I and II. Results: Forty-three OSA patients (29 M, 16 F, mean age 52.26 +/- 11.40) and 43 healthy controls (25 M, 18 F, mean age 49.95 +/- 7.59) were included in the study. No significant differences were found between groups in demographic data. TMD prevalence and Axis II results did not differ between groups. Conclusions: This paper does not highlight a higher prevalence of TMDs in adults with OSA compared to healthy controls. Further high-quality studies are needed to confirm the results and to give possible pathophysiological explanations, providing reliable evidence

Dialogue as a tool in peacebuilding. Theoretical and empirical perspectives.

The thesis discusses dialogue as a tool in peacebuilding. The problem statement raises the need for knowledge of what dialogue is, competence in how to employ dialogue and adherence to the use of dialogue, for it to be a tool in peacebuilding. Through the ontological position of constructivism, I argue for a reconstruction of the term dialogue. The thesis aims to develop on a theoretical framework for defining dialogue. Dialogue is defined as a form of communication with the goal to understand the other. To inform and challenge the definition of dialogue, I collected empirical data from dialogue experts in Norway and data from the United Nations. Based on the data, I discuss dialogue as an attitude and a culture in the analysis. Further, the analysis discuss requirements, limitations and effects of dialogue. The thesis argues that change and cooperation are possible effects of dialogue, rather than integral parts of dialogue as a form of communication. I present Bernstein’s theory of framing as a measure to analyse dialogue as a tool in peacebuilding. Strong framing regulates ‘what can be said’, ‘where’ and ‘by whom’ and is thus a limitation for dialogue. Through Jakobson’s model of communication, I argue that dialogue attributes different meaning to the functions in language than other forms of communication. Dialogue has an emotive and relational function, including context, feelings and the whole person when understanding the other. Through Lotman’s theory on semiosphere, I inform that dialogue is an exchange of information, requiring both difference and similarities. Codes translate the information from the contexts of the sender and the receiver. Drawing on Lotman’s theory, I argue that there is a difference between translation and interpretation. Addressing hermeneutics, I argue that there is a difference between interpretation of text and interpretation in dialogue, drawing on Gadamer. Further, drawing on Habermas, I argue that interpretation is inhibiting in dialogue as I have the possibility to ask question to the subject. Peacebuilding is defined through Galtung and Lederach. Drawing on Smith’s pallet of peacebuilding, dialogue is defined as an integral part of peacebuilding. I argue that it is due to the goal of dialogue as understanding that dialogue can be a tool in peacebuilding. Understanding builds relations and can have positive effects. I take a critical view of dialogue used to achieve other goals, as a misuse of the term. Dialogue is thus a tool for understanding, which can be used as a tool in peacebuilding. Dialogue can be a sustainable tool in peacebuilding as it can contribute to adaptability, as defined by Lederach. The thesis further argues that the United Nations has a low visibility of their work and definition of dialogue

Lectura crítica de Correa, Sonia y Pecheny, Mario. (2016). Abortus Interruptus. Política y reforma legal del aborto en Uruguay. Montevideo: MYSU. 106 páginas.

El libro Abortus interruptus. Política y reforma legal del aborto en Uruguay es una obra que recopila los antecedentes y los principales avances en la legislación uruguaya en relación a la Interrupción Voluntaria del Embarazo (IVE) y el acceso al aborto legal, seguro y gratuit

Lectura crítica de Correa, Sonia y Pecheny, Mario. (2016). Abortus Interruptus. Política y reforma legal del aborto en Uruguay. Montevideo: MYSU. 106 páginas.

El libro Abortus interruptus. Política y reforma legal del aborto en Uruguay es una obra que recopila los antecedentes y los principales avances en la legislación uruguaya en relación a la Interrupción Voluntaria del Embarazo (IVE) y el acceso al aborto legal, seguro y gratuit

Upper Airway Collapsibility during Sleep Endoscopy with a Titratable Mandibular Advancement Simulator in Obstructive Sleep Apnea Patients

Drug-induced sleep endoscopy (DISE) has been progressively used to determine the individual patient responsiveness to therapy with a mandibular advancement device (MAD) for obstructive sleep apnea (OSA). This retrospective cohort study compared the general and polygraphic characteristics, as well as the sites, degrees, and patterns of upper airway collapse, in patients who responded to advancement with a titratable mandibular advancement (TMA) simulator during DISE—referred to as responders—to those in non-responders. The sample included 335 OSA patients (307 males) with a mean age of 49.98 (SD = 9.88) years, and a mean AHI of 34.14 (SD = 18.61). Once the TMA simulator customized to the patient’s dental arches was inserted and the examination was performed at 0%, 25%, 50%, and 75% of the patient’s range of antero-posterior mandibular excursion, the simulator was removed and the upper airway behavior was studied in the baseline situation. Without TMA simulator non-responders had a higher percentage of oropharyngeal complete latero-lateral and complete concentric velopharyngeal collapse. With TMA simulators, there was a significant difference between responders and non-responders in individual obstructive sites at velopharyngeal, oropharyngeal, and epiglottis levels, while at the tongue level, responders and non-responders showed the same response tendency. If confirmed in future prospective studies, these results suggest that the presence of complete latero-lateral obstruction at the oropharynx level and complete circular obstruction at the velopharynx level could be adverse phenotypes for MAD treatment outcomes in OSA patients and MAD treatment should not be considered in these patients (at least as a single therapy)

Magnetic susceptibility as a 1-year predictor of outcome in familial cerebral cavernous malformations: a pilot study

Objectives: To test whether quantitative susceptibility mapping (QSM) of cerebral cavernous malformations (CCMs) assessed at baseline may predict the presence or absence of haemorrhagic signs at 1-year follow-up. Methods: Familial CCM patients were enrolled in the longitudinal multicentre study Treat-CCM. The 3-T MRI scan allowed performing a semi-automatic segmentation of CCMs and computing the maximum susceptibility in each segmented CCM (QSMmax) at baseline. CCMs were classified as haemorrhagic and non-haemorrhagic at baseline and then subclassified according to the 1-year (t1) evolution. Between-group differences were tested, and the diagnostic accuracy of QSMmax in predicting the presence or absence of haemorrhagic signs in CCMs was calculated with ROC analyses. Results: Thirty-three patients were included in the analysis, and a total of 1126 CCMs were segmented. QSMmax was higher in haemorrhagic CCMs than in non-haemorrhagic CCMs (p < 0.001). In haemorrhagic CCMs at baseline, the accuracy of QSMmax in differentiating CCMs that were still haemorrhagic from CCMs that recovered from haemorrhage at t1 calculated as area under the curve (AUC) was 0.78 with sensitivity 62.69%, specificity 82.35%, positive predictive value (PPV) 93.3% and negative predictive value (NPV) 35.9% (QSMmax cut-off ≥ 1462.95 ppb). In non-haemorrhagic CCMs at baseline, AUC was 0.91 in differentiating CCMs that bled at t1 from stable CCMs with sensitivity 100%, specificity 81.9%, PPV 5.1%, and NPV 100% (QSMmax cut-off ≥ 776.29 ppb). Conclusions: The QSMmax in CCMs at baseline showed high accuracy in predicting the presence or absence of haemorrhagic signs at 1-year follow-up. Further effort is required to test the role of QSM in follow-up assessment and therapeutic trials in multicentre CCM studies. Key points: • QSM in semi-automatically segmented CCM was feasible. • The maximum magnetic susceptibility in a single CCM at baseline may predict the presence or absence of haemorrhagic signs at 1-year follow-up. • Multicentric studies are needed to enforce the role of QSM in predicting the CCMs' haemorrhagic evolution in patients affected by familial and sporadic forms